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7.5.3 Finger Feeding

Finger feeding is an alternative feeding method when an infant is unable to breastfeed. It can also be used for modification of inappropriate sucking technique.

Finger feeding may be used by the health professional and parents can very ably continue at home. It is seen as an alternative to cup feeding1 and a hospital study in Australia used finger feeding to substitute bottlefeeding in preterm infants who displayed faulty sucking techniques and found that it increased breastfeeding rates at discharge by 30% to 71%.2

When to consider finger feeding

Finger feeding may be considered:
  • the infant is unable to grasp the breast - affected by maternal medications during birth, trauma impairing cranial nerve function, tongue-tie, low tone conditions
  • the infant is refusing the breast
  • mother has severely damaged nipples requiring rest during healing process - this is helpful to the mother and may also serve as a suck therapy for the infant during this time
  • as a 'pre-breastfeed' enticer for infants suffering from confusion or dysfunctional suck problems.
Finger feeding avoids the complications of bottlefeeding for a breastfed infant.
The feeder is able to feel the tongue action and respond with milk flow accordingly or stimulate the palate or tongue as required. The infant should be able to efficiently coordinate breathing and sucking if using this method.

Preparation

Infant to be ready for a feed
Infant supported on a pillow or on the lap of the feeder person.

Equipment

  • Syringe - regular or periodontal curved-tip OR soft feeding bag and feed line
  • Breastmilk or substitute at room temperature
  • Pillow or towel roll
  • Gloves (for all except infant's own parents)

Finger feeding technique

The feeder controls the flow of milk according to the infant's sucking. The tip of the syringe is placed next to the feeder's finger, not pushing on the baby's mouth.

Be consistent in the technique used for finger placement, and utilize the same positioning principles as used when feeding at the breast:
  • Infant well supported down the back
  • Infant's body in alignment with his head; neck slightly extended

The feeder washes hands - Note: health professionals to use a gloved finger:
  • The feeder uses their finger with nail-side down and soft pad of finger to the palate.
  • The feeder's finger begins curled and uses the knuckle to stimulate the top lip and encourage tongue extension and gap.
  • Uncurl the finger under the top lip and introduce it along the palate.
  • Keep finger directly down midline during feeding.
  • Once sucking has commenced, insert syringe in corner of infant's mouth against the feeder's finger. Push very small aliquots of milk (approx 0.5ml) into infant's mouth to stimulate continued sucking.
  • Follow infant's lead with sucking bursts - only push milk in when infant is sucking, or stimulate suck recommencement by massaging the palate.
Note: if using soft feeding bag with feed line, place bag in palm of feeder's hand and tape tubing alongside gloved finger.

Important tip!

The infant oral cavity is very sensitive. Fingers come in all different shapes and sizes so to avoid confusion and desensitization of the infant, limit the number of different people who perform this procedure. Parents are very capable of taking on this task and teaching them will give them confidence.

Finger feeding instruction sheet

Click on this PDF hospital information page for parents on finger feeding.
Does your unit or practice have an information sheet like this? If not, research the topic further and produce your own.

Teach finger feeding

Step 1 - Stimulate gape and uncurl finger onto tongue.

Step 1 - Stimulate gape and uncurl finger onto tongue.
© B.Ingle IBCLC

Step 2 - Introduce syringe tip alongside finger keeping finger down midline of palate and infant's head slightly extended.

Step 2 - Introduce syringe tip alongside finger keeping finger down midline of palate and infant's head slightly extended.
© B.Ingle IBCLC

Notes

  1. # Marmet C et al. (2000) Assessing infant suck dysfunction: case management.
  2. # Oddy WH et al. (2003) Implementing the Baby Friendly Hospital Initiative: the role of finger feeding.